BACKGROUND: About 20% of major depressive episodes become chronic and medication-refractory and also appear to be less responsive to standard cognitive-behavioural therapy (CBT). AIMS: To test whether CBT developed from behavioural activation principles that explicitly and exclusively targets depressive rumination enhances treatment as usual (TAU) in reducing residual depression. METHOD: Forty-two consecutively recruited participants meeting criteria for medication-refractory residual depression were randomly allocated to TAU v. TAU plus up to 12 sessions of individual rumination-focused CBT. The trial has been registered (ISRCTN22782150). RESULTS: Adding rumination-focused CBT to TAU significantly improved residual symptoms and remission rates. Treatment effects were mediated by change in rumination. CONCLUSIONS: This is the first randomised controlled trial providing evidence of benefits of rumination-focused CBT in persistent depression. Although suggesting the internal validity of rumination-focused CBT for residual depression, the trial lacked an attentional control group so cannot test whether the effects were as a result of the specific content of rumination-focused CBT v. non-specific therapy effects.
RCT Entities:
BACKGROUND: About 20% of major depressive episodes become chronic and medication-refractory and also appear to be less responsive to standard cognitive-behavioural therapy (CBT). AIMS: To test whether CBT developed from behavioural activation principles that explicitly and exclusively targets depressive rumination enhances treatment as usual (TAU) in reducing residual depression. METHOD: Forty-two consecutively recruited participants meeting criteria for medication-refractory residual depression were randomly allocated to TAU v. TAU plus up to 12 sessions of individual rumination-focused CBT. The trial has been registered (ISRCTN22782150). RESULTS: Adding rumination-focused CBT to TAU significantly improved residual symptoms and remission rates. Treatment effects were mediated by change in rumination. CONCLUSIONS: This is the first randomised controlled trial providing evidence of benefits of rumination-focused CBT in persistent depression. Although suggesting the internal validity of rumination-focused CBT for residual depression, the trial lacked an attentional control group so cannot test whether the effects were as a result of the specific content of rumination-focused CBT v. non-specific therapy effects.
Authors: Maxime Taquet; Jordi Quoidbach; James J Gross; Kate E A Saunders; Guy M Goodwin Journal: JAMA Psychiatry Date: 2020-09-01 Impact factor: 21.596
Authors: Katie L Burkhouse; Rachel H Jacobs; Amy T Peters; Olu Ajilore; Edward R Watkins; Scott A Langenecker Journal: Cogn Affect Behav Neurosci Date: 2017-04 Impact factor: 3.282
Authors: David A Kalmbach; Daniel J Buysse; Philip Cheng; Thomas Roth; Alexander Yang; Christopher L Drake Journal: Sleep Med Date: 2019-11-14 Impact factor: 3.492
Authors: Amy T Peters; Rachel H Jacobs; Claudia Feldhaus; David B Henry; Anne Marie Albano; Scott A Langenecker; Mark A Reinecke; Susan G Silva; John F Curry Journal: J Adolesc Health Date: 2015-11-11 Impact factor: 5.012